Provider Demographics
NPI:1023103249
Name:ST. DAVID HOME HEALTH, INC.
Entity type:Organization
Organization Name:ST. DAVID HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:APODACA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSING
Authorized Official - Phone:713-414-5438
Mailing Address - Street 1:7322 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 490
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2010
Mailing Address - Country:US
Mailing Address - Phone:713-414-5438
Mailing Address - Fax:713-414-5439
Practice Address - Street 1:7322 SOUTHWEST FWY
Practice Address - Street 2:SUITE 490
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2010
Practice Address - Country:US
Practice Address - Phone:713-414-5438
Practice Address - Fax:713-414-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010073251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677975Medicare ID - Type Unspecified